摘要
目的：分析低度恶性子宫内膜间质肉瘤（ESS）的超声特点，降低术前误诊率。方法：回顾性分析11例经手术及病理证实的低度恶性ESS的超声表现。结果：11例患者中，7例病灶位于肌壁间，4例位于宫腔；最大直径长径20~130 mm，平均为50.7 mm；形态为椭圆形8例、不规则2例、类圆形1例；边界清晰7例，不清晰4例；病灶内部回声均不均匀，低回声为主8例，等回声为主3例；呈“斑片状”表现6例，筛孔状暗区3例，中间为等回声，外周为低回声2例。4例合并其他疾病的低度恶性ESS病灶回声均与合并疾病病灶回声不一致。11例病灶中边缘及内部均可探及彩色血流信号，RI 0.41~0.78。结论：当超声发现肿瘤边界不清晰，向肌层浸润可能；内部回声不均匀，呈“斑片状”；子宫肿瘤内常合并其他性质病灶存在，而呈现多个病灶回声不一致声像；肿瘤边缘及内部探及中量血流，尤其是月经增多的育龄妇女，应警惕低度恶性ESS发生。
Abstract
Objective: To summarize the sonographic characteristics of low-grade uterine endometrial stromal sarcoma(LGESS) for reducing the preoperative misdiagnosis rate. Methods: Sonographic findings were retrospectively analyzed in 11 cases with LGESS confirmed by surgery and pathology. Results: The tumors appeared as intramural masses in 7 cases and endometrial masses in 4 cases. The maximum diameter was 20 mm to 130 mm with a mean diameter of 50.7 mm. The lesions were oval(n=8), irregular (n=2) or almost round(n=1). The margins were smooth(n=7) or ill-defined(n=4). Eight lesions were heterogeneously hypoechoic and 3 were heterogeneously intermediate echoic. There were 3 types of ultrasonic menifestations of LGESS: patchy echogenicity(n=6), with tiny cystic spaces(n=3) and hyperechoic center with hypoechoic surroundings(n=2). The echo texture of the original lesions was different from their complications in 4 cases. Blood flow was seen by color Doppler imaging in all cases with resistance between 0.41~0.78. Conclusion: The sonographic charactersitics of LGESS included ill-defined margin with possible infiltration to the myometrium, heterogeneous patchy echogenicity, tumor echo different from the complications and a medium vascularity. When detecting these findings in premenopausal women, especially with hypermenorrhea, the diagnosis of LGESS should be considered with very high probability.
关键词
肉瘤 /
子宫内膜间质 /
超声检查 /
多普勒 /
彩色
Key words
Sarcoma /
endometrial stromal /
Ultrasonography /
Doppler /
color
陈 丹;马小燕;张江宇;刘永熙;周晓莹.
低度恶性子宫内膜间质肉瘤的超声表现分析[J]. 中国临床医学影像杂志. 2014, 25(11): 797-799
CHEN Dan;MA Xiao-yan;ZHANG Jiang-yu;LIU Yong-xi;ZHOU Xiao-ying.
Sonographic findings of low-grade endometrial stromal sarcoma[J]. Journal of China Clinic Medical Imaging. 2014, 25(11): 797-799
中图分类号：
Ｒ738.7
R737.33
Ｒ445.1
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